Abstract:
BACKGROUND:Enhanced recovery after surgery (ERAS) programs are designed to reduce hospital length of stay by shortening the postoperative recovery period. The intended effect of an accelerated recovery on the length of stay may be frustrated by a delayed discharge. This study was designed to assess the influence of an ERAS program on the proportion, appropriateness, and extent of delay in discharge. METHODS:Patients who enrolled in the ERAS program (n = 121) between 2003 and 2006 were compared with 52 patients who were managed traditionally in 2001. RESULTS:Ninety percent of the pre-ERAS patients and 87% of the ERAS patients were not discharged on the day that discharge criteria were fulfilled. The additional stay of 59% of the pre-ERAS patients and 69% of the ERAS patients was inappropriate. Wound care (15% in the pre-ERAS and 3% of the ERAS group) and observation of any symptoms pointing to an anastomotic leakage (10% in both groups) were the most important reasons for a medical appropriate delay of discharge. The extent of delay in discharge decreased significantly from a median of two days in the pre-ERAS group to a median of 1 day in the ERAS group (p = 0.004). CONCLUSIONS:Reductions in length of stay up to a median of 2 days after start of an enhanced recovery program may relate to changes in organization of care and not to a shorter recovery period. Recovery statistics should replace or at least be added to the length of stay as outcome of enhanced recovery programs.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Maessen JM,Dejong CH,Kessels AG,von Meyenfeldt MF,Enhanced Recovery After Surgery (ERAS) Group.doi
10.1007/s00268-007-9404-9subject
Has Abstractpub_date
2008-06-01 00:00:00pages
971-5issue
6eissn
0364-2313issn
1432-2323journal_volume
32pub_type
杂志文章abstract::Intraperitoneal forgotten foreign bodies are prone to create adhesions and to encapsulate, or to provoke an exudative response, with or without accompanying bacterial infection. Often a process of self-extrusion is initiated. This is also true for gossypibomas, retained surgical sponges. Presentation is possible as a ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689910084
更新日期:2000-05-01 00:00:00
abstract::From January, 1972 to June, 1989, 51 patients with liver hemangiomas (32 females and 19 males, mean age 35 years) were evaluated for surgical treatment. Diameters of the masses were 5 cm to 20 cm (median 8.5 cm). Nine of the patients had already been treated for cancer. Twenty-two (43.1%) of the 51 patients were sympt...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02104457
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the efficacy of the Nd:YAG laser for treating stage I squamous cell carcinoma (SCC) of the lip. The retrospective study was performed in a tertiary care referral hospital in northern India. METHODS:In January 2007 the records of patients treated by Nd:YAG laser ablation o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9363-1
更新日期:2008-04-01 00:00:00
abstract::Although emergency department thoracotomy (EDT) is often considered a controversial "last chance" method of resuscitation, we hypothesized that EDT performed in a busy urban Level I trauma center has significant salvage rates despite the absence of traditional survival predictors. A retrospective review revealed that ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9392-9
更新日期:2008-04-01 00:00:00
abstract:INTRODUCTION:Despite formal definitions of mucinous cystic neoplasms (MCNs) and intraductal papillary neoplasms (IPMNs) by the World Health Organization (WHO) and Armed Forces Institute of Pathology (AFIP), several controversies with regard to MCNs remain. The aim of this review was to determine the clinicopathological...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-006-0126-1
更新日期:2006-12-01 00:00:00
abstract::The rectal electrical activity recorded by electrorectogram (ERG) was studied in 22 chronically constipated subjects and 16 healthy volunteers. The latter had a mean (+/- SD) age of 42.6 +/- 8.5 years; 10 were men and 6 women. Of the 22 constipated patients, 14 had inertia-type constipation (IC; age 44.6 +/- 10.2 year...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00295930
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Parathyroid glands can mimic thyroid follicular lesions on fine-needle aspiration (FNA) cytology and can lead to unnecessary or incorrect surgery. Newer molecular panel tests using next-generation sequencing (NGS) include analysis of cell type-specific gene expression profiles such as parathyroid. The study ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4548-3
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Recurrent spontaneous pneumothorax is widely treated by video-assisted thoracoscopic (VATS) bullectomy and pleurodesis. Treatment of postoperative pain with nonsteroidal antiinflammatory drugs (NSAIDs) is controversial as many surgeons believe that it reduces the efficacy of pleurodesis and increases the pne...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1207-3
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The survival outcome in lung cancer patients with chronic kidney disease (CKD) has not been well evaluated. The aim of this study was to evaluate the survival outcomes following non-small cell lung cancer (NSCLC) surgery in patients with CKD as a preoperative comorbidity. METHODS:Among 671 patients who unde...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05143-3
更新日期:2019-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900631
更新日期:1999-11-01 00:00:00
abstract::There has been a long, unresolved debate regarding the operation of choice for well differentiated carcinoma of the thyroid. We therefore analyzed the feasibility, scope, sample size, and length of follow-up required to determine the optimal operation for papillary thyroid carcinoma. A statistical approach was used to...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900016
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:A recent analysis found bradycardia during laparoscopy as a potential early warning sign of cardiac arrest. Knowledge regarding bradycardia frequency and its consequences during laparoscopy is limited. METHODS:Using the computerized record database, files of 9915 patients undergoing laparoscopic surgery, be...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-04935-x
更新日期:2019-06-01 00:00:00
abstract::Pancreas transplantation has emerged as the single most effective way to achieve normal glucose homeostasis inpatients with type I insulin-dependent diabetes mellitus. Optimal immunosuppressive strategies for pancreas transplantation continue to evolve with the use of newer, more potent immunosuppressive agents,partic...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-001-0207-0
更新日期:2002-02-01 00:00:00
abstract:INTRODUCTION:Covid-19 has had a significant impact on all aspects of health care. We aimed to characterise the trends in emergency general surgery at a district general hospital in Scotland. METHODS:A prospective cohort study was performed from 23/03/20 to 07/05/20. All emergency general surgery patients were included...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05760-3
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:With the progressive use of new diagnostic techniques, the management of penetrating abdominal stab wounds is changing. Most studies have been conducted in well-equipped trauma centers in developed countries, and there is a paucity of reports from general teaching hospitals with limited resources. We reviewe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-1931-y
更新日期:2013-05-01 00:00:00
abstract::This article presents an analysis of acute gastroduodenal mucosal lesions (AGML) based on a review of current literature and the personal experience of the authors. The pathology of AGML involes two distinct types of lesions, namely, superficial erosions confined to the acid-secreting gastric mucosa and presenting as ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654729
更新日期:1977-01-01 00:00:00
abstract::Central pancreatectomy is an uncommonly performed procedure that may be particularly useful for the removal of benign and low malignant potential lesions in the neck and body of the pancreas. This procedure may have fewer major complications and better preserve endocrine and exocrine function than the more commonly pe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6848-4
更新日期:2003-05-01 00:00:00
abstract::Blood loss during liver transection and ischemia-reperfusion injury associated with hepatic inflow occlusion are significant drawbacks during liver surgery. Sixteen patients underwent liver resection using the Monopolar Floating Ball (FB) plus LigaSure (LS) diathermy without occlusion of the hepatoduodenal ligament (g...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7167-5
更新日期:2004-02-01 00:00:00
abstract::Expression of sialyl-Lewisx (sLex) antigen was studied immunohistochemically in 110 resected human gastric carcinomas using an anti-sLex monoclonal antibody. Lymph node, liver, and peritoneal metastases were clearly more prevalent in tumors expressing high levels of sLex than in those with no or low-level sLex express...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900304
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Variously described as Courvoisier's law, sign, or even gallbladder, this eponymous "law" has been taught to medical students since the publication of Courvoisier's treatise in 1890. METHODS:We reviewed Courvoisier's original "law," the modern misconceptions surrounding it, and the contemporary evidence sup...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00268-008-9908-y
更新日期:2009-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3924-8
更新日期:2017-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658439
更新日期:1989-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1507-2
更新日期:2012-06-01 00:00:00
abstract::TraumAID is a computer-based decision aid that uses decision rules and logical deduction to generate management plans for the initial definitive management of injured patients; its use is currently confined to assessing penetrating thoracoabdominal injuries in nonpregnant adults. These management plans were compared t...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00268-001-0263-5
更新日期:2002-05-01 00:00:00
abstract::Benign esophageal obstruction is virtually always responsive to dilation therapy. Dilation therapy should, therefore, be the initial approach. The introduction of the Savary-type dilating equipment and of balloon dilation systems are, or will become, standard practice. These systems will increasingly be preferred over...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658390
更新日期:1989-03-01 00:00:00
abstract::We sought to determine whether early eschar excision en masse (EEE) at one operation would be effective in the prevention and treatment of postburn organ dysfunction (OD) and multiple organ dysfunction syndrome (MODS). A total of 60 patients, with total body surface burned area over 35% and a third degree burn area ov...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900661
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Traditional perioperative care for colonic surgery in elderly patients is associated with increased morbidity and mortality compared to that of younger patients. Although multimodal perioperative rehabilitation has evolved as a valid concept to improve postoperative outcome, its use has not yet been establis...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-009-0018-2
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Laparoscopic resection of posterosuperior (PS) tumors of the liver is more difficult than that of anterolateral (AL) tumors, owing to the narrow surgical field in the PS location. In this retrospective cohort study, our aim was to determine if port insertion through the intercostal space would lead to improv...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3867-5
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Trauma contributes more than ten percent of the global burden of disease. Initial assessment and resuscitation of trauma patients often requires rapid diagnosis and management of multiple concurrent complex conditions, and errors are common. We investigated whether implementing a trauma care checklist would ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3759-8
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Laparoscopic cholecystectomy (LC) with common bile duct exploration (LCBDE) is nowadays a preferred one-stage treatment. However, the influence of complicated cholecystitis (CC) on LCBDE has rarely been addressed. In the present study we aimed to verify whether severe gallbladder inflammation would adversely...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1696-8
更新日期:2012-10-01 00:00:00